Phone adaptor gives doctors closer look at patients' eyes

Published 4:27 pm, Sunday, April 27, 2014

Dr. David Myung (left), Alexandre Jais and Dr. Robert Chang test the EyeGo retina examination adapter, below, a device used with an iPhone that allows physicians to take pictures of the front and back of the eye. less

Dr. David Myung (left), Alexandre Jais and Dr. Robert Chang test the EyeGo retina examination adapter, below, a device used with an iPhone that allows physicians to take pictures of the front and back of the ... more

The iPhone may be a phone that plays music and surfs the Internet, but it can also be a phone for the, well, eye.

Ophthalmologists at Stanford University School of Medicine recently developed small, inexpensive devices that allow smartphones to take high-quality photos of the front and back of the eye. The intent is to give eye doctors an easy way to share those images with each other, store the information in patients' electronic records and remotely diagnose problems, said Dr. David Myung, who helped invent the technology called EyeGo.

The global market for ophthalmology diagnostics and surgical devices is expected to grow from $26 billion in 2012 to $40 billion in 2019, according to a Transparency Market Research report this month.

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The need for such tools is increasing because eye-related disorders like diabetic retinopathy and macular degeneration are becoming more widespread, especially among the growing elderly population, the report said.

Optometrists and ophthalmologists could more easily track eye diseases with the EyeGo, said Dr. Ranjeet Bajwa, an optometrist in Bakersfield and a trustee at the California Optometric Association who was not involved with the Stanford project. And doctors without the traditional, expensive cameras could use their phones to take pictures of eye problems.

Benefits touted

"It will allow us to utilize the lenses and smartphones many of us already own and use on a daily basis to capture retinal photography for clinical documentation and patient education," Bajwa said in an e-mail. "The benefits of such a device are numerous."

The standard cameras used to photograph the eye cost thousands of dollars and require extensive training, but the Stanford researchers say their devices could remotely provide eye care in rural regions where such equipment is rare.

Even in fully modern health care facilities, communication can be a problem, as Myung learned when he interned at Kaiser Permanente more than two years ago. Health care workers sometimes had trouble capturing and sharing images of patients' eye problems with ophthalmologists.

Once Myung started a residency in ophthalmology at Stanford in 2012, "I was getting calls - from outside the clinic, inpatient hospitals, the ER, all over the place - saying, 'I have a patient with an eye problem' and describing it to me over the phone," Myung recalled. "In my mind, I'm trying to get a picture of what a patient's eye looks like."

'Better than words'

That frustration convinced him, he said, that "pictures are better than words." At the same time, Myung realized that smartphones had become both ubiquitous and deft at taking high-quality pictures.

So Myung, who'd previously trained as an engineer, teamed up with Dr. Robert Chang, an assistant professor of ophthalmology at the university, to develop a set of 3-D-printed, pocket-size adapters for the phone, which they described in papers published last month in the Journal of Mobile Technology in Medicine.

One device consists of a low-cost macro lens and an LED light that clip onto a smartphone's camera lens. Together, they take high-resolution pictures of the front of the eye, which can then be uploaded and shared with staff. The researchers say the device generates pictures faster and more easily than the usual equipment: a slit lamp, or a microscope with an adjustable, high-intensity light.

Back of the eye

Figuring out how to photograph the back of the eye was a little more complicated. Eventually, the team mounted a phone on a device that holds a lens at a distance from the camera. The lens focuses light onto the eye in a way that allows for good pictures beyond the pupil and iris.

The team is still figuring out how best to protect patients' images if their devices become commercially available, and they're exploring the possibility of selling the devices in conjunction with apps that comply with patient-privacy laws.

Other scientists are working on similar ways to make eye care easier. A team at Massachusetts Institute of Technology has developed Catra, a cheap, compact eyepiece that attaches to a cell phone, and detects and quantifies cataracts.

Myung and Chang say each of their devices costs $65 or less to make, and the cost of 3-D printing continues to fall. Stanford has provided seed grants to make the first batch of adapters for research. Colleagues are testing the inventions in the emergency department and on diabetic patients with eye disease. The team is hoping to license the technology and someday get federal approval to sell to whoever wants it.

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